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心脏移植中扩大供体库的策略

Strategies for Expanding Donors Pool in Heart Transplantation.

作者信息

Jacob Samuel, Garg Pankaj, Wadiwala Ishaq, Yazji John H, Alomari Mohammad, Alamouti-Fard Emad, Akram Hussain Md Walid, Pham Si M

机构信息

Department of Cardiothoracic Surgery, Heart and Lung Transplant Program, Mayo Clinic, Jacksonville, FL 32224, USA.

Research Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA.

出版信息

Rev Cardiovasc Med. 2022 Aug 15;23(8):285. doi: 10.31083/j.rcm2308285. eCollection 2022 Aug.

Abstract

Heart transplant remains the criterion standard treatment for patients in end-stage heart failure. Improvement in the post-heart transplant outcomes in the last decade has contributed to increased demand for organs. Worldwide each year, more than 5000 heart transplants are performed and 50,000 people become candidates for heart transplant. In the last 50 years, there have been several attempts to expand donor criteria to increase the donor pool. Despite making hepatitis C virus, opioid overdose death, old age allowable and changing the allocation system, the gap between supply and demand is widening and unfortunately, thousands die every year waiting due to the critical shortage of organs. New technologies for heart donation after circulatory death have emerged, particularly normothermic regional organ perfusion and heart perfusion using organ care systems. However, these technologies still do not fill the gap. Continuous advancements in areas such as regenerative medicine and xenotransplantation, among others, are needed to overcome the shortage of heart donors for heart transplantation.

摘要

心脏移植仍然是终末期心力衰竭患者的标准治疗方法。在过去十年中,心脏移植术后结果的改善导致了对器官需求的增加。在全球范围内,每年进行超过5000例心脏移植手术,有5万人成为心脏移植的候选者。在过去50年里,人们多次尝试扩大供体标准以增加供体库。尽管已将丙型肝炎病毒感染、阿片类药物过量致死、高龄纳入供体范围并改变了分配系统,但供需差距仍在扩大,不幸的是,每年都有成千上万人因器官严重短缺在等待中死亡。循环死亡后心脏捐献的新技术已经出现,特别是常温局部器官灌注和使用器官护理系统进行心脏灌注。然而,这些技术仍然无法填补缺口。需要在再生医学和异种移植等领域不断取得进展,以克服心脏移植心脏供体短缺的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e32/11266976/0932d0d9d958/2153-8174-23-8-285-g1.jpg

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